21 yrs boy came with a/h/o Human bite over rt.side of upper back. no history of rvd. please suggest management.

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Human bite management 1) Clean with normal saline and betadin 2) Keep the wound open 3) Use oral antibiotics 4) Give hepatitis B vaccination - of previously vaccinated then check HbSAb antibody level 5) Gives tetanus immunization three doses 0,1 and 6 in case if previous immunization is incomplete or not known 6) check HIV, HCV and HbSAg in the affected person as well as person who has bitten - if possible 7) Give HIV post exposure Prophylaxis if person who has bitten is HIV positive or HIV status unknown- after counseling and explaining pro and cons 3-drug PEP regimen is raltegravir 400 mg PO twice daily plus Tenofovir DF 300 mg once a day with Emtricitabine 200 mg PO once daily

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Wash the wound with running soap water then y betaine lotion. Inj tet toxoid °5 ml im No stiches is advisable Now the question wheatear bite pt should be given antiravies injection or not. Some are against inj ARV are against as human saliva does not contain rabies virus. But some say rabies virus travel to brain through nerve cell and virus reproduces then travel back through nerves to all the parts of body including salivary gland and secreted throughs saliva. If to give then on day. 0, 3, 7, 14, and 28 th day.

Human bites should be flushed with an antiseptic solution such as povidone iodine 1%, followed by normal saline (salt water) solution. Dead, damaged, or infected tissue from the wound site as well as tooth fragments or other foreign bodies may have to be removed from the wound. The patient may need stitches. However, human bite wounds to the hand usually are left open for a while because leaving the wound open can lessen the chance of infection from bacteria. Puncture wounds, wounds that are already infected, or wounds older than six to 12 hours should be left open. The wound may be partially closed with adhesive strips before it is stitched. In most cases, facial bite wounds are stitched immediately.

Inj TT .5ml im stat. Clean area with diluted betadine iotion Apply muprocine oint locally. Antibiotics and analgesic orally. Check wound for any FB etc.

Thanks Dr Dinesh Gupta
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Rabipur on 03714-28 as given in dog bite Inj tetvac or tetglob 250 I u Antibiotics orally antibiotics locally

Tnx Dr Aditya
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Injection TT, wash wound with Betadine, oral antibiotics and analgesics

Thank you, Doctor
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Thanks Dr sharma, Dr kalbhande, Dr pal for detailed information.

SUGGESTIVE OF HUMAN. BITES ADVISABLE INJ. T T WOUND. CARE. AS. PER. PROTOCOL ANTIBIOTICS ANTIINFLAMMATORIES

Wash wound with betadine TT. Hep.B Antibiotics Analgesics

Clean with soap and water Inj. T.T. .5ml im Inj. ARV .1 ml 0,3,7 , 28 th day

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